Abstract
BACKGROUND: Schizophrenia often has hallucinations, delusions and other complex mental symptoms, metacognitive training (MCT) is a type of low-intensity group training. However, MCT requires a lot of time and expense, increasing the workload of professionals and the financial burden of patients. hybrid offline-online MCT reduces time and economic costs to the greatest extent. This study was designed to validate the interventional effects of a hybrid offline-online MCT model on psychiatric symptoms, delusion severity, and insight in patients with schizophrenia, while concurrently evaluating its clinical applicability. METHODS: Randomized controlled trials comparing hybrid offline-online MCT were conducted in patients with paranoid schizophrenia. The positive and negative syndrome scale (PANSS), the Chinese version of the delusion feature rating scale (C-CDRS), the Chinese version of the psychotic symptom rating scale (PSYRATS), and the insight and treatment attitude questionnaire (ITAQ) were used to evaluate psychiatric symptom improvement and insight in the baseline (T0), 4 weeks after the initiation of training (T1), and upon completion of the training (T2, week 8). RESULTS: The total scores of PANSS, C-CDRS, PSYRATS, and their subscale scores in the MCT and control groups were lower than baseline scores at weeks four and eight, while the total ITAQ score was higher than baseline scores (P < 0.01). In the MCT group, PANSS positive subscale and total score, C-CDRS total score, and PSYRATS delusion subscale and total score were lower than those in the control group at weeks four and eight, whereas the ITAQ total score was higher than the baseline score (P < 0.01). CONCLUSIONS: Hybrid offline-online group MCT can reduce positive symptoms in patients with schizophrenia, alleviate delusions, and improve patients' insight. TRIAL REGISTRATION: The trial was registered at the Chinese Clinical Trial Registry on 01/24/2015 ( www.chictr.org.cn ; ChiCTRID: ChiCTR2500096505).